Diabetes Flashcards
What drugs are classed under sulphonyureas, MOA, and what counselling points should be given?
GLICLAZIDE, Glibenclamide, Glimepiride, Glipizide
MOA: increase pancreatic insulin secretion, may decrease insulin resistance
Counselling: Risk of hypo so take with food, alcohol decreases blood glucose and masks signs of hypo- drink with care and have something to eat alongside, make sure you, friends and family can all recognise signs of hypo
May cause weight gain, upset stomach, diarrhoea
What drugs are classed under Dipeptidyl peptidase-4 inhibitors, MOA, and what counselling points should be given?
Linagliptin, saxagliptin, Vildagliptin, Sitagliptin, Alogliptin
MOA: Inhibit DPP-4 (enzyme that breaks down GLP-1), increasing conc of incretin hormones like GLP-1 so glucose-dependant insulin secretion is increased and glucagon production reduced
Can take with or without food
May cause hypo, headache, musculoskeletal pain
What drugs are classed under Glucagon-like peptide-1 analogues, MOA, and what counseling points should be given?
Dulaglutide, Exenatide, Liraglutide, Semaglutide
MOA: Increase glucose-dependant insulin and suppress inappropriate glucagon secretion. Also delays gastric emptying, slowing glucose absorption and decrease appetite.
May cause nausea, vomiting (usually improves with time), changes in stools, dyspepsia, injection site reaction, hypo, severe abdominal pain (seek advice from your doctor)
What drugs are classed under Sodium-glucose co-transporter 2 inhibitors, MOA, and what counseling points should be given?
Dapagliflozin, empagliflozin, ertugliflozin
MOA: Inhibit SGLT2, reduce glucose reabsorption in the kidney and increase excretion
Genital infections, dyslipidaemia, hypo, euglycaemic ketoacidosis (rare but serious- N&V, abdominal pain)
Make sure to drink enough water to control thirst, more likely to get genital infections so watch for signs of infection and seek medical advice if they do occur, can be taken with or without food
Acarbose MOA and counselling points?
MOA: delays intestinal absorption of carbohydrates by inhibiting enzymes in the small intestine, reduces postprandial hyperglycaemia
Risk of hypoglycaemia
Side effects include flatulence, diarrhoea, abdominal pain
Swallow whole with a glass of water before a meal or chew with the first few mouthfuls of food
GI effects increased by taking sucrose, so better to use glucose
Insulin MOA and counselling points?
MOA: Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake, inhibit endogenous insulin output and lipolysis
Hypo (either insufficient food or increased physical activity, or excessive insulin dosage)- (warning signs include sweating, hunger, faintness, headache, confusion, irritability,) weight gain, injection site reactions
Alcohol decreases BG and masks signs of hypoglycaemia, let friends and family know signs of hypo, rotate injection sites to prevent damage to the fat and tissues under the skin, wait 30 min after taking out of the fridge to inject, gently roll in hands before use
Metformin MOA and counselling points?
MOA: Reduces hepatic glucose production, increases peripheral utilisation of glucose
Side effects include nausea, vomiting, diarrhoea, lactic acidosis
Take with food to minimise stomach upset, talk to your doctor if you’re experiencing loss of appetite, N&V, diarrhoea, abdominal pain
Drinking can lower BG and mask signs of a hypo
Pioglitazone MOA and counselling points?
Regulates genes involved in lipid and glucose metabolism, increases sensitivity of peripheral tissues to insulin, decreases hepatic glucose output
Side effects include peripheral oedema, weight gain, headache, dizziness, liver and heart complications
Tell your doctor if you notice blood in your urine or urinating becomes painful
